Fine-needle aspiration cytology of localized fibrous tumor of pleura

Our plain-English summary of Fine-needle aspiration cytology of localized fibrous tumor of pleura, by D. Dusenbery, M.M. Grimes, W.J. Frable (Diagnostic Cytopathology, 1992).

The study

• Authors: D. Dusenbery, M.M. Grimes, W.J. Frable
• Journal: Diagnostic Cytopathology
• Published: 1992;8(5):444-50
• Type of article: Case report
• Cited by: 27 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Fine-needle aspiration (FNA) biopsy findings are presented in three cases of localized fibrous tumor of pleura (LFTP). Clinically, two of the tumors behaved benignly, although one showed frequent mitoses and foci of necrosis. The third tumor exhibited local aggressiveness as evidenced by rib destruction. Cytologically, these tumors exhibited a wide range of cellularity, composed mainly of small, bland oval to spindle cells with moderate numbers of stripped nuclei. Small bits of collagen were seen in the smears. In all cases, cell blocks were instrumental in making the diagnosis. Previous cytologic descriptions of the tumor are briefly reviewed and the cytologic differential diagnosis is discussed. The peripheral location of this uncommon tumor makes it an ideal target for FNA biopsy.

In plain English

This article reported three cases of localized fibrous tumor of pleura, a tumor also known as localized fibrous mesothelioma. It described how samples taken by fine-needle aspiration (a thin-needle biopsy) looked under the microscope. The patients were women aged 76, 49 and 61. No asbestos exposure was reported; the 49-year-old was described as a moderate cigarette smoker taking replacement estrogen and progesterone. Two tumors behaved benignly. The 76-year-old was well, without evidence of disease, 1 year after surgery, and the 49-year-old was well 5 months after surgery. The third tumor grew into nearby soft tissue and rib, and that patient was well about 2 months after surgery. The needle samples from the first two cases contained few cells, while those from the third were highly cellular. In all three cases, cell blocks (solid preparations made from the sample) were instrumental in reaching the diagnosis. The authors cautioned that predicting tumor behavior from needle findings seemed tenuous at best. The authors concluded that, in the proper clinical and radiologic setting, these features should lead doctors to consider this diagnosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series (three case reports) describing fine-needle aspiration cytology of localized fibrous tumor of pleura, a tumor also called localized fibrous mesothelioma, with a brief review of earlier published descriptions
• Who was studied: Three women with localized fibrous tumor of pleura, aged 76, 49 and 61. Cases were from the Medical College of Virginia (Richmond, VA), and case 3 was contributed by physicians in Joplin, Missouri.
• Exposure: No asbestos exposure history was reported for any patient. Case 2 (the 49-year-old) was described as a moderate cigarette smoker who was taking replacement estrogen and progesterone. The study itself concerned fine-needle aspiration biopsy findings, not an exposure.
• Main results:
  • Case 1 (76-year-old woman): the tumor weighed 1,589 g and measured 18.5 x 15.0 x 9.5 cm. It showed up to 7 mitoses per 10 high-power fields and focal necrosis. The patient was well without evidence of disease 1 year after surgery.
  • Case 2 (49-year-old woman): the tumor measured 13.0 x 12.0 x 4.6 cm and was attached by a pedicle to the visceral pleura. The patient was well 5 months after thoracotomy.
  • Case 3 (61-year-old woman): the tumor infiltrated adjacent soft tissue and rib, and the resection included segments of five ribs. The patient was well with no evidence of recurrence about 2 months after thoracotomy.
  • The needle samples from the two clinically benign tumors (cases 1 and 2) had relatively low cellularity. The sample from case 3, the clinically malignant tumor, was extremely cellular.
  • In all three cases, the cell block preparation was instrumental in reaching a diagnosis.
• The authors' conclusion: The authors concluded that when these cytologic features are seen in the proper clinical and radiologic setting, localized fibrous tumor of pleura should be considered. They added that a diagnosis by needle biopsy before surgery may help direct surgical treatment.
• Limitations the authors state:
  • The authors stated that predicting tumor behavior from needle biopsy findings seemed tenuous at best. Benign tumors may have highly cellular areas, and malignant tumors may have areas with few cells, and either could be what the needle samples.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Fine-Needle Aspiration, Cytology, Solitary Fibrous Tumor, Pleura, Biopsy, Necrosis, Spindle Cell, Collagen.

Related studies

• Malignant localized fibrous tumor of the pleura occurring in a person environmentally exposed to tremolite asbestos — M. Metintas, A.R. Gibbs, et al. (1997)
• The potential value of comparative genomic hybridization analysis in effusion-and fine needle aspiration cytology — H. Nagel, H.J. Schulten, et al. (2002)
• Thoracic splenosis diagnosed by fine-needle aspiration cytology: a case report — S. Syed, P. Zaharopoulos (2001)
• Fine-needle aspiration cytology of multicystic mesothelioma — K. Devaney, P.J. Kragel, et al. (1992)
• Rounded atelectasis: diagnosis by fine-needle aspiration cytology — W.T. Miller, P.K. Gupta, et al. (1992)
• Localized fibrous "mesothelioma" of pleura (submesothelial fibroma): a clinicopathologic study of 18 cases — D. Scharifker, M. Kaneko (1979)

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